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12 hours following in geography a patient develops a painful pulsatile mass just below the skin at the femoral artery function site. A femoral artery bruit can be heard with the stethoscope. What is the most likely complication?

False aneurysm

What is a bruit?

Turbulent sound - blood leaving vessel and gurgling into the neck of the pseudoaneurysm

You have health pressure on a heart cath patients RSA for 15 minutes. You slowly remove your fingers and see that the bleeding has stopped. But, you know a soft and stable quarter inch high swelling, about 1 inch in diameter. You should:

Circle the swollen area with a pen and then watch the puncture site for 2 to 3 minutes more for further swelling.

True or false: if a hematoma continues to grow after you circle the swollen area with a pen you have hemostasis

False, you only have hemostasis if it stops growing

You have held pressure on a heart cath patients RFA for 15 minutes. You slowly remove your fingers and see that the bleeding has stopped. You feel a new hard 2 inch wide swelling beneath the puncture site. You should

Continue compression for 20 more minutes

On which IV access site is hemostasis most difficult to achieve?

Subclavian vein

After a diagnostic RFA cath, the catheter has been removed, sheath flushed & ECG leads removed. Pt has minor bleeding around sheath site. The Pt needs to be moved to a holding area where you will pull the sheath. How should he be moved to the stretcher?

Hold the patient's groin at the sheath insertion site while coworkers slide him over on a roller board or surfboard

When instructing a Pt after femoral arteriography, all the directions below are ok except: press on wound if you have to cough, drink lots of fluids, elevate the head of the bed no higher than 30 degrees, you may get up to go to the bathroom

The patient should be instructed not to get up to go to the bathroom

True or false: a Post radial arteriography patient may have the head of the bed elevated 90 degrees

true

**How long should pressure be applied post cath?

10 minutes for everyone + 2 minutes per sheath size

After Lt heart cath + coronary arteriography the femoral artery sheath is pulled out of the artery and homeostasis is established. To accomplish this the puncture site should normally be held for --to --Min. with pressure at the vascular puncture site

10 to 20 minutes, 2 to 3 fingers digital

You are about to establish hemostasis following RFA catheterization. Prior to pulling the sheath you should position your

Left index finger just superior to the skin puncture

***When pulling a sheath, how much pressure should be exerted on the femoral artery, after initial bleeding has been stopped?

just enough so a faint pulse is felt in the foot for 5 minutes, then taper off (patent hemostasis, not occlusive)

*After a Rt + Lt heart cath from the Rt leg, Both arterial and venous sheets remain in the groin. The safest method to establish hemostasis for both vessels is to:

First remove the arterial sheath and apply pressure to that site for 15 minutes and then remove the other sheets and hold pressure on the vein for 10 minutes

When palpating pedal pulses during hemostasis the posterior tibial artery is located

Behind the medial malleolus (ankle bone)

Hemostasis is defined as:

The act of stopping bleeding. It is the body's natural response to vascular injury. It occurs in a series of steps that results in a fibrin clot.

Why would a patients ability to clot be affected by liver disease?

Because they don't make fibrinogen

Why would a patients ability to clot be affected by thrombocytopenia?

They don't have enough platelets.

The patients ability to clot may be affected by:

The administration of anticoagulants, decreased vascular tone of the vessel, liver disease, thrombocytopenia

Prior to selecting a method of hemostasis the following variables should be assessed: